Individual
DR. JUAN R LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
6941 W GORE BLVD, LAWTON, OK 73505-5311
(580) 536-9647
(580) 536-4075
Mailing address
6941 W GORE BLVD, LAWTON, OK 73505-5311
(580) 536-9647
(580) 536-4075
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
05022
OK
Other
Enumeration date
06/08/2007
Last updated
07/08/2007
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